Xiong Ruo-Fei, Lu Shan-Shan, Wu Zhi-Ming, Huang Hong-Jun, Xiao Tao
Department of General Surgery, Shaoxing Central Hospital, Shaoxing 312000, Zhejiang Province, China.
Department of Geriatrics, Shaoxing University Affiliated Hospital, Shaoxing 312000, Zhejiang Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):102697. doi: 10.4240/wjgs.v17.i4.102697.
At present, there are few studies on the risk factors for bile leakage after laparoscopic common bile duct exploration (LCBDE) for older patients with choledocholithiasis.
To identify the potential risk factors for bile leakage after LCBDE in older patients.
A retrospective, single-center observational analysis was performed on patients aged ≥ 70 years with choledocholithiasis treated by LCBDE who were admitted to our center between January 2011 and August 2022. The included patients were divided into non-bile leakage and bile leakage groups. Risk factors were determined by analyzing the observation indicators.
Seventy older patients with choledocholithiasis who underwent LCBDE were included. Univariate analysis showed that positive culture of bile bacteria was a risk factor for bile leakage after LCBDE ( < 0.05). We further analyzed the bile bacteria, and univariate analysis showed that () ( < 0.05) and ( < 0.05) were associated with an increased risk of postoperative bile leakage in older patients ( < 0.05). Multivariate analysis showed that was an independent risk factor for postoperative bile leakage in older patients ( < 0.05). The results of antibiotic sensitivity analysis showed that had 100% susceptibility to penicillin, ampicillin, linezolid, vancomycin, and furantoin.
-associated biliary tract infection is an independent risk factor for bile leakage after LCBDE in older patients with choledocholithiasis. We suggest coverage with antibiotics to which is sensitive.
目前，关于老年胆总管结石患者腹腔镜胆总管探查术（LCBDE）后胆漏危险因素的研究较少。
确定老年患者LCBDE术后胆漏的潜在危险因素。
对2011年1月至2022年8月在本中心接受LCBDE治疗的年龄≥70岁的胆总管结石患者进行回顾性单中心观察分析。将纳入的患者分为非胆漏组和胆漏组。通过分析观察指标确定危险因素。
纳入70例接受LCBDE的老年胆总管结石患者。单因素分析显示，胆汁细菌培养阳性是LCBDE术后胆漏的危险因素（<0.05）。我们进一步分析胆汁细菌，单因素分析显示（）（<0.05）和（<0.05）与老年患者术后胆漏风险增加相关（<0.05）。多因素分析显示，是老年患者术后胆漏的独立危险因素（<0.05）。抗生素敏感性分析结果显示，对青霉素、氨苄西林、利奈唑胺、万古霉素和呋喃妥因的敏感性为100%。
相关胆道感染是老年胆总管结石患者LCBDE术后胆漏的独立危险因素。我们建议使用对敏感的抗生素进行覆盖。
